胰腺是兼具外分泌与内分泌功能的关键器官，其功能障碍既可引发急性胰腺炎（AP）、胰腺癌（PC）等疾病，也可导致以胰岛β细胞损伤为核心的糖尿病（DM）。临床治疗手段有限，预后欠佳。铁死亡是一种铁依赖性、以脂质代谢物蓄积为特征的新型程序性细胞死亡方式，在DM胰岛β细胞损伤、AP腺泡细胞破坏及PC恶性进展中发挥关键作用。中药具有多成分、多靶点、整体调节的优势，在调控铁死亡方面展现出巨大潜力。研究发现，中药活性成分忍冬苷、汉黄芩素、槲皮素等及中药复方玉液汤、大承气汤、健脾化瘀方等可通过干预铁代谢、脂质代谢、谷氨酸/胱氨酸逆向转运体（System Xc^-）/谷胱甘肽（GSH）/谷胱甘肽过氧化物酶4(GPX4)、核因子E2相关因子2(Nrf2)、肿瘤蛋白53(p53)等铁死亡相关通路，双向调节铁死亡过程，从而在胰腺相关疾病中发挥保护或抗肿瘤作用。系统综述铁死亡在胰腺疾病中的作用机制，并重点梳理中药通过调控铁死亡治疗上述疾病的研究进展，以期为临床防治与新药研发提供理论依据。

The pancreas is a key organ with both exocrine and endocrine functions. Its dysfunction can lead to diseases such as acute pancreatitis(AP) and pancreatic cancer(PC), as well as diabetes mellitus(DM), which is characterised by damage to pancreatic islet β cells. Clinical treatment options are limited, and the prognosis is poor. Ferroptosis is a newly discovered form of programmed cell death that is iron-dependent and characterised by the accumulation of lipid metabolites, playing a critical role in β cell damage in diabetes, acinar cell destruction in acute pancreatitis, and malignant progression of pancreatic cancer. Traditional Chinese medicine(TCM) has the advantages of multiple components, multiple targets, and holistic regulation, showing great potential in regulating ferroptosis. Studies have found that active components of TCM such as lonicerin, baicalin, quercetin, and TCM formulas like Yuye Decoction, Da Chengqi Decoction, and Jianpi Huayu Fang can intervene in ferroptosis-related pathways by modulating iron metabolism, lipid metabolism, the cystine/glutamate antiporter(System Xc^-), glutathione(GSH), glutathione peroxidase 4(GPX4), nuclear factor erythroid-2-related factor 2(Nrf2), and tumor protein p53, thereby bidirectionally regulating the ferroptosis process and exerting protective or anti-tumour effects in pancreatic-related diseases. This article systematically reviews the mechanisms of ferroptosis in pancreatic diseases and highlights the research progress of TCM in treating these diseases through the regulation of ferroptosis, with the aim of providing a theoretical basis for clinical prevention and new drug development.

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国家自然科学基金项目(82104833); 河南省中医药传承与创新人才工程(仲景工程)中医药学科领军人才项目(豫卫中医函[2021]8号); 河南省中医药科学研究专项(20-21ZY2049);河南省中医药科学研究专项(2023ZY1014)